Fixing addiction from the ground up

In this photo taken on Feb 11, 2013, freshly dumped hypodermic syringes and a needle litter an abandoned cemetery in Myitkyina, the provincial capital of Kachin state, Myanmar. Myitkyina is known for having one of the highest concentrations of drug addicts in the world. The Kachin Baptist Convention, an evangelical group with over 300 churches in the state, says nearly 80 percent of ethnic Kachin youth are addicts. Their drug of choice is heroin. In the shadow of war, even drug abuse becomes politicized. Gryung Heang, the pastor of the camp church, says the government is willfully turning a blind eye to drug abuse among the Kachin because it wants to decimate young potential fighters. Officials say such views are absurd. (AP Photo/Gemunu Amarasinghe)

Chief Robert MacKenzie runs a police department in Kennebunk, Maine, a town of just over 11,000 citizens. It is a tourist town with a small, tight knit community on the coast. His plans to fix the opioid crisis in America, however, are anything but small. 

Maine sits near the top of a notorious list, ranked in the top ten for most opioid deaths in the country. In 2016, there were 301 opioid related overdose deaths in Maine, a rate of 25.2 deaths per 100,000 persons, nearly double the national rate. Maine has struggled with drug problems for years, and the solutions have been slim and ineffective from the statehouse in Augusta. 

Chief MacKenzie believes that is to be expected. “State and federal governments can’t and won’t fix this problem,” he told me. “Our communities are the ones who can.” 

Chief MacKenzie does more than talk. He has invested years into a grassroots effort that puts lifesaving medicine into the hands of the public through a local training program called the Recovery Coach Academy.

The coastal Maine community has become enamored with the program, and more than 300 citizens from all walks of life have been trained and are now equipped with Naloxone, more commonly known as NARCAN. Administered via the nose, NARCAN is the single most effective tool for instantly stopping an opioid overdose. With the help of Chief MacKenzie’s program, someone with little or no medical background can administer the treatment to an overdose victim.

Naloxone blocks neural receptors which leads to the immediate loss of “feeling high” and stops the opioid from acting as a respiratory depressant. In other words, by immediately stopping the drug from working, NARCAN prevents the most common form of overdose death: when an individual stops breathing.  More important than the drug, according to Chief MacKenzie, is the focus on putting people first. 

The Recovery Coach Academy trains volunteers to help get individuals who suffer from addiction, also referred to as Substance Abuse Disorder, into treatment programs that can help provide long term solutions. Though data on the program’s effectiveness is not readily available, Chief MacKenzie cited multiple cases in which individuals with extensive criminal histories were able to get treatment through this relationship building approach. He believes these individuals “would never have otherwise sought treatment.”

Chief MacKenzie’s ideas about Substance Abuse Disorder, however, are not universally held. Even in the medical community, there are loud voices who criticize his work. Medical professionals see firsthand the impact of a NARCAN safety net, and question whether mass availability is a solution, or simply a stepping stone to a greater problem.

I spoke with an EMT who shared her experience with me on the condition of anonymity. She was concerned that speaking up on the proliferation of NARCAN could have a negative impact on her professionally.

“In the mind of an active IV drug user, he isn’t worried about dying, he’s worrying about withdrawal,” the EMT said. “What they think is, why should I be afraid of using if I always have access to NARCAN?”

Though their policies are different, her concerns ended up sounding similar to Chief MacKenzie’s: a passionate plea to stop the problem before it begins, and a desire to remove incentives for people to use opioids in the future.

“I think people who would otherwise stay away from opioids might try them if NARCAN is common, because they have a safety net. Just trying an addictive drug will lead to more addiction,” she said.

The issue stretches beyond moral and ethical grounds. In Maine and elsewhere, financial concerns are mounting. Providing NARCAN costs money, and Maine in particular faces age and job problems that stymie economic growth. In addition, many find the practice to be outside the proper role of government. 

The solution, it seems, are private grants – which Chief MacKenzie is pursuing. To successfully win private funding, data gathering is a necessary bureaucratic step. 

“Yes, it costs money now” says Chief MacKenzie; “But there are financial benefits for everyone in the long run.”

In Kennebunk, a grassroots support network is taking the problem head on by throwing events and raising money to ensure programs can provide education and supplies to the growing group. A local event in Kennebunk hosted by a non-profit organization called Above Board raised more than $56,000 in a single evening this past August to ensure that the program can succeed. 

As communities continue to support grassroots movements to combat the opioid crisis, the number of lives saved continues to grow. In Kennebunk, Chief MacKenzie has found that relationship building and support networks prove to be a more effective remedy to drug issues.

It is a complex issue, but there are some harsh realities we must face as it relates to the opioid crisis in our country. It will take much more than government programs to effectively combat this crisis, and incarcerating drug users is not the answer.


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